This proposal is for the Pennsylvania College of Optometry (Pennsylvania College of Optometry) to serve as one of 9 clinical centers in the Convergence Insufficiency Treatment Trial (CITT). The CITT is a multicenter clinical trial designed to compare the effectiveness of two common treatment approaches for patients [unreadable] with convergence insufficiency (CI). In the proposed study, 249 patients between the ages of 9 and 30 years will be randomly assigned to: 1) home-based pencil push-up treatment, 2) office-based vision therapy/orthoptics, or 3) placebo office-based vision therapy/orthoptics. Measurements of the signs and symptoms of CI will be made at baseline, and by [unreadable] masked examiners every 4 weeks during the 12-week treatment phase. Patients who are considered successfully treated (based on symptoms) at 12 weeks will be followed for an additional 12 months. The primary outcome variable will be the score on the Convergence Insufficiency Symptom Survey. Secondary measures will include the near point of convergence and positive fusional vergence at near. Our objective at this Clinical Center will be randomize at least 30 patients in 18 months. This application documents the ability of Pennsylvania College of Optometry to recruit at least 30 patients within 18 months, and to retain patients who are successful after 12 weeks of treatment for one year after completion of treatment. Documentation is also provided that Pennsylvania College of Optometry has the [unreadable] personnel, equipment, and facilities to conduct the study in accordance with the CITT Manual of Procedures (MOP). Complete details of the CITT rationale, design, and methods are contained in the MOP, which is submitted separately with the Study Chair and Data Coordinating Center applications. In addition to Pennsylvania College of Optometry, there will be 8 other optometric/ophthalmologic clinical centers with the Study Chair at the Pennsylvania College of Optometry and the Data Coordinating Center at The Ohio State University Optometry Data Coordinating Center. [unreadable] [unreadable]